Therapy

I’ve written about schema therapy in the past. I’ve never actually undergone the therapy itself; rather, I did the assessment and was able to change my behaviour based on 2 books I read.

I know, I know. I have to stop trying to do everything myself. At the time, the psychologist I was seeing had only just heard about the therapy and hadn’t been trained in it. The look of panic on his face when I let down the facade and let the child modes come out kinda confirmed that I should just stick to theory.

And it worked. It had a huge impact. The constant panic cleaning and adrenaline mostly went away. I’d correct myself when I was being too hypercritical. I was able to chillax and am relatively laid back compared to the agitated stress freak I am when I’m not coping.

It was interesting to note that unrelenting standards was one of my core schemas when I had a recent assessment.

Note: this isn’t me trying to self-treat or fix everything myself. It’s a lot easier to give up control to someone who is trained and can make the most impact. I just love nerding out on this and want to intellectualize 🙂

What are my current schemas?

According to the questionnaire, they are:

‘Social Isolation

Failure to achieve

Unrelenting standards

Approval-Seeking/Recognition-Seeking

I think this is fascinating; especially since I did the assessment 2-3 months ago. I believe that the social isolation one would be different now but but again, I’m being a nerd. I’m tempted to seek out another questionnaire to test that theory but don’t want to interfere with treatment.

In 2013, they were identified as follows:

Rated 9+:

Unrelenting standards

Dependence/incompetence

Vulnerability

Rated 8

Social isolation

Mistrust/abuse

I find this fascinating. I was so focused on the top two issues – dependence/incompetence and unrelenting standards – that I had forgotten about the social isolation aspect. When I got told the results, I dismissed this schema saying that it was likely due to relapsing. Something to keep in mind with future treatment.

It was 2013. I was struggling very much with my mental health issues and it felt like I wasn’t making much progress. I was a quick thinker and was doing quite well with the CBT techniques I was learning about. My main problem was that I didn’t have the logic to back up the information I was telling my brain during CBT. I can be quite argumentative, even within my own brain, and I was getting exhausted fighting the anxious part of my brain.

My psychologist introduced me to the idea of schema therapy and I filled out some questionnaires. I read the basic material he gave me. I was so intrigued by the theory that I bought a couple of books, including one targeted at psychologists. It was eye opening for me. It completely reframed how I perceived my mental illness, considerably moreso then the knowledge I was figted.

The theory can be a bit complex and difficult to wrap your head around at times. I found it easier to forget about the therapeutic aspect and just learn about the model. I did the tests and learned about my own schemes and coping modes. I agreed with what I was reading.

So, What Is Schema Therapy?

Schema Therapy places a greater emphasis on the childhood origins of psychological problems. It is an integrative therapy, combining aspects of cognitive, behavioural, psychodynamic, attachment and Gestalt models. It sees the cognitive and behavioural aspects as vital to treatment, as in standard CBT, but gives equal weight to emotional change, experiential techniques and the therapeutic relationship. Like CBT, it is structured, systematic and specific. It follows a sequence of assessment and treatment procedures. The model outlines specific schemas, coping styles and modes.

I’ve always seen CBT as flawed. You learn how to deal with the negative thought patterns. Schema therapy allowed me to go one step back – to look at the motivations for certain behaviour, especially behaviour that triggered me.

The four main concepts in the Schema Therapy model are: Early Maladaptive Schemas, Core Emotional Needs, Schema Mode, and Maladaptive Coping Styles.

The 18 Early Maladaptive Schemas are self-defeating, core themes or patterns that we keep repeating throughout our lives.

Early Schemas relate to the basic emotional needs of a child. When these needs are not met in childhood, schemas develop that lead to unhealthy life patterns. Each of the 18 schemas represent specific emotional needs that were not adequately met in childhood or adolescence.

Maladaptive Coping Styles are the ways the child adapts to schemas and to damaging childhood experiences. For example, some children surrender to their schemas; some find ways to block out or avoid pain; while other children fight back or overcompensate.

Schema Modes are the moment-to-moment emotional states and coping responses that we all experience. Often our schema modes are triggered by life situations that we are oversensitive to (our “emotional buttons”). Many schema modes lead us to overreact to situations, or to act in ways that end up hurting us.

I’ll cover these details later. I provided that information now so that you understood that everything here is part of a larger framework.

I did the tests and learned that I had two primary schemas:

Unrelenting Standards

Dependence, incompetence

It was an ‘aha!’ moment, especially with unrelenting standards. I’ll provide some context of the illness first.

Patients with this particular schema “present as perfectionistic and driven. They believe that they must continually strive to meet extremely high standards.” (Schema Therapy: A Practitioner’s Guide ). The authors went on to say “the most typical emotion experienced by patients with the Unrelenting Standards schema is pressure. This pressure is relentless.”

Huh. Additionally, those with the schema experience a lot of exhaustion and irritability as a result of both working so hard to reach their goals AND not being able to always do so.

This was mind blowing for me. I could use this. Very quickly, I was able to tell whether a specific action was triggered by a schema. I could use what information I’d read to help me figure out what was triggering me and how I could fight it. However, knowing my schemas was only the first step in the process. The next steps was figuring out how I coped when the schemas are triggered.

When I was originally learning about schema therapy, there were three main ways of coping with specific schemas. Schema Therapy London provided one of the simplest overviews:

It is through these three styles that schemas exert their influence on our behaviour and work to insure their own survival.

Schema surrender refers to ways in which we sometimes passively give in to our schema. We accept the schema as truth and then act in ways that confirm the schema.

Schema avoidance refers to the ways in which we do anything we can to avoid activating schemas. As mentioned earlier, when schemas are activated, this causes extreme negative emotion. So we might find ways to avoid triggering schemas in order not to feel this pain. There are three types of schema avoidance: cognitive, emotional and behavioral.

The third schema process is Schema overcompensation. The individual behaves in a manner which appears to be the opposite of what the schema suggests in order to avoid triggering the schema. On the surface, it may appear that the overcompensators are behaving in a healthy manner, by standing up for themselves. But when they overshoot the mark they cause more problem patterns, which then perpetuate the schema.

Damn! I was able to apply these coping styles to specific schemas. It appeared that a lot of the time I overcompensated with unrelenting standards by just letting all my standards go. In addition, there are schema modes. It is probably too difficult to go into that within the context of what is meant to be an introductory article.

~

I’ve suffered from severe anxiety for my whole adult life. It is debilitating, exhausting and has impacted on my life. Learning about this technique helped me change a lot of my behaviour and reduced the physical stress on my body. It allowed me to adjust my actions in my relationship with Glenn. Our relationship improved significantly after that.

I’m writing about it because I think it is worth exploring within the framework of giftedness, and because I think it should be something everyone looks into. It is definitely something I’ll be exploring later.

One of the main reasons I’ve been able to make so much progress over the past year has been due to schema therapy. It’s incredibly hard to explain, but I will be exploring a lot of the concepts through this blog as part of my research.

I’m not sure that I believe in a lot of the stuff around schemas. We haven’t tried triggering my schemas in sessions or anything, nor do we really done much work challenging them.

I prefer to use them to describe certain rigid mindsets I get when I am triggered. Learning about how we maintain, avoid and compensate for triggers was incredibly helpful for me. I was able to change my behaviour. Here, I’ll be focusing on how cope with certain mindsets. You don’t need to know anything about the therapy itself for this to make sense.

Schema maintenance refers to the routine processes by which schemas function and perpetuate themselves. This is accomplished by cognitive distortions and self-defeating behavior patterns. Cognitive distortions are a central part of cognitive therapy. These distortions consist of negative interpretations and predictions of life events. Many cognitive distortions are part of the schema maintenance process. The schema will highlight or exaggerate information that confirms the schema and will minimize or deny information that contradicts it. Schema maintenance works behaviorally as well as cognitively. The schema will generate behaviors which tend to keep the schema intact.

This is part of the reason I struggled with anxiety so much. Negative interpretations clouded everything and my exhaustion made it hard to fight with them. I wouldn’t try to challenge these thoughts when I was exhausted. I would do that on my good days (by researching or talking with my pysch) so I had the information to ‘cognitively restructure’ later. I don’t really know what that is – my psych explained it to me when I was telling him how I challenge my anxiety a lot because the thoughts are stupid and I know they are illogical. He said I had an intuitive understanding. Sidenote: does intuitively knowing your mind/body work for OR against you when it comes to recovering from a mental illness?

I see schema maintenance as being one part of a framework. Just being aware that certain thoughts are maintaining a negative mindset is enough. It’s data that you can use as part of getting treatment.

Schema avoidance refers to the ways in which people avoid activating schemas. As mentioned earlier, when schemas are activated, this causes extreme negative emotion. People develop ways to avoid triggering schemas in order not to feel this pain. There are three behaviors of all schema avoidance: cognitive, emotional and behavioral. Cognitive avoidance refers to efforts that people make not to think about upsetting events. These efforts may be either voluntary or automatic. People may voluntarily choose not to focus on an aspect of their personality or an event which they find disturbing. There are also unconscious processes which help people to shut out information which would be too upsetting to confront. Emotional or affective avoidance refers to automatic or voluntary attempts to block painful emotion. Often when people have painful emotional experiences, they numb themselves to the feelings in order to minimize the pain. The third type of avoidance is behavioral avoidance. People often act in such a way as to avoid situations that trigger schemas, and thus avoid psychological pain.

I don’t avoid situations because I’m scared of leaving the house or I’m scared of being uncomfortable. A lot of my avoidance is because my thought processes will take me to a deep dark place very quickly once triggered.

One of my main issues has been work. I’ve been incredibly sick for the past year or so. Effexor stopped being as effective so I could only work about 10 hours a week. I struggled during those hours.

My mind would instantly go from “I’m having a bad week” to “I’m going to be sick forever and be a drain on society.” I’d then progress to “I’ll never contribute anything great” to “if my life is going to be this mediocre then I may as well just die.” I still get like this. It’s no biggie and isn’t worth worrying about; I have an illness and I’m getting treated for it.

However, it really helped me to recognize that I wasn’t being lazy. My mind was just avoiding triggers that would take it to an incredibly dark place. If I got into that place, I would start experiencing physical symptoms and my anxiety would be worse. My mind was just trying to protect itself.

I’m very hard on myself but seriously, I’m bloody impressed with how awesome my brain is in regards to keeping me alive.

Schema Compensation is when the individual behaves in a manner which appears to be the opposite of what the schema suggests in order to avoid triggering the schema.

I used to overcompensate by cleaning. “I can’t control everything so I am going to have a very tidy house!” The only problem is that I was triggered when I was cleaning and actually tidying things up made me feel worse. Glenn would actually tell me to slow down or even stop because I looked kinda manic.

It has been hard to not compensate for the schema because it means challenging those icky thoughts. Honestly, who actually enjoys confronting everyone of their insecurities head on? It has been useful, though, as I can stop certain behaviours before I make myself even more anxious.